Optimizing PEEP in Laparoscopic Bariatric Surgery Using Bedside Lung Ultrasound

Cairo University (CU)

Status: Completed

Conditions: Atelectasis, Postoperative Pulmonary

Treatments: Device: stepwise PEEP

Study type: Interventional

Funder types: Other

Identifiers

NCT04269564

MS-263-2019

Details and patient eligibility

About

Lung ultrasound imaging is a promising non-invasive, non-radiant, portable and easy to use tool that as yet to be studied in the intraoperative setting.

in our current study, we are trying to reach the optimum PEEP in laparoscopic bariatric patients to prevent postoperative collapse and atlectasis with simple non-invasive procedure.

Enrollment: 40 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• they are between 18 and 65 years of age
• BMI more than 35
• patients with normal respiratory functions
• ASA 1 or 2

Exclusion criteria

• Previous lung surgery
• Bronchial asthma
• Contralateral lung bullae 4. Uncompensated cardiac disease (NYHA class 3 or 4) 5. Obstructive or restrictive lung disease 6. Patients on home oxygen therapy 7. Hemodynamic instability and increased intracranial pressure 8. In adittion , any patient who developes hemodynamic instability (MAP <60mmHg) or hypoxia (Po2 less than 60) during the study will excluded from the study

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

40 participants in 2 patient groups

group A

No Intervention group

Description:

Group A patients received the standard ventilation protocol as follows: volume-controlled ventilation mode, with VT 6 ml/kg of ideal body weight, inspiratory : expiratory ratio 1 : 2, a PEEP of 4 cmH2O, and respiratory rate 10-12 breaths/min that will be adjusted to keep end-tidal carbon dioxide tension (EtCO2) between 35 and 40 mmHg and inspired oxygen fraction of 0.5.

group B

Active Comparator group

Description:

Patients in group B received the standard ventilation protocol with stepwise peep until end of surgery and extubation.

Treatment:

Device: stepwise PEEP